33
cates some of the changes characteristic of these
benign nodules. In one case (No. 33), in addition

to adenomatoid nodules there also was present a
Hurthle’s cell adenoma.In anothercase (No.61),
one pathologist remarked that “some observers
might regard the large nodule as a follicular adenoma.” In subject No. 59, a 46-year-old woman

whohad receivedless than half the radiation dose
of the other cases with nodules, there was a solitary
adenomatous nodule, well circumscribed, and the

surrounding thyroid tissue was normal in appearance. This was in contrast to the other cases in

whom the glands were almost entirely abnormal
in-appearance. A 41-year-old woman (No. 64) had
a mixed papillary and follicular carcinomaof the

thyroid with localized metastasis to a blood vessel

and lymph node (Figure 26). Following complete
thyroidectomy by surgery and therapeutic ‘*']
no recurrence or further metastasis has been noted.

In September 1966, at Tripler Genera! Hospital,
Hawaii, thyroid uptake studies following TSH

stimulation (10 units daily for 2 days), thyroid
scans, andskeletal surveys for metastasis showed
absence of the thyroid and no detectable metastasis.*
Thyroid Function Tests Related
to Thyroid Abnormalities and Growth Retardation
In Table 20 the cases with thyroid abnormalities are listed along with the growth status of children andresults of thyroid function tests. The re-

sults of kinetic analysis of '**I tests are given in

Table 21. Two 12-year-old boys (No. 5 and No. 3)

Figure 24. Benign thyroid nodules at surgery. Top: ex-

posed thyroid with arrows pointing to nodules. Bottom:

sectioned gland from another case. Note multinodular,

cystic, and hemorrhagic natureof gland.

Microscopic Appearance.

The microscopic ap-

pearanceof all the benign nodular glands in the
children was characteristic of adenomatousgoiter
and varied mainly in the degree of change. The
architecture of the gland was disrupted by the
nodules of widely varying sizes. Some of the nodules contained microfollicular elements with and
without colloid, others were atrophic, some contained large cysts with colloid, some with hemorrhage, andstill others showed extensive proliferation of the epithelial layers with marked infolding,

giving an “arboreal” appearance. Figure 25 indi-

who had been exposed at 15 and 18 monthsof age
respectively have hadthe greatest retardation of
growth and development. Subject No. 3 had
shown no changein bone maturationsince 1961
and until recently had the bone ageof a 3-year
old child. The bone age of No. 5 has shown continuing slow growth and in 1965 was 5%years.
Both these boys in 1965 had the height of normal
7-year old Marshallese boys. Their dwarfism was
particularly evident in comparison with younger

siblings who weretaller than they. In 1965 it was
found that in both cases the levels of proteinboundiodine had dropped below 2 ug%. Before
that time, they had levels considered to be in the

normal range, and there was no reasonto relate
their dwarfism to hypothyroidism. With the development of the low PBIs they showed definite
“Weare grateful to Major Ronald Moore, MC, USA, for car-

rying out these examinations.

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